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Then there’s the exercise programme. I realise now that this programme is mainly about weight training, starting carefully and gradually increasing intensity. There are detailed instructions and references. For the first few days, I feel both uplifted and lost. I print out the programme and make a little folder, then I sit down and Google the exercises to get the right balance and technique. YouTube turns out to be full of American muscle men who demonstrate in less than four minutes how to lift weights, while talking enough to give the expression ‘detailed description’ a new meaning. I watch these videos when I don’t understand something, then try it for myself. Above all, I’m buoyed by the feeling of having a plan at the gym. Most of it goes well, but some of the new exercises fill me with anxiety.
On one list is ‘dead lift’. I Google my American muscle-building guides and see a man with a barbell on the ground in front of him. On the barbell are large round weights. He bends over and grips the bar with both hands then lifts it up with straight legs and straight hips, with the bar hanging in his arms. He says that this is the Rolls-Royce of exercises, with a gigantic effect on strength and back health, and that every fibre in the body becomes activated. I see how his whole back tautens and feel sheer terror.
How will I manage this?
I go to the gym to try it out, and I’m able to lift 2 kilograms in each hand, with bent knees. Then I feel a pulling in my back. When I look around, people are lifting 30, 35 or 40 kilograms in the same exercise. Dead lifts are not my thing. Not at all my thing.
My first real setback comes a few days later.
I still don’t understand why, but I develop an abscess in one armpit. It starts out as a small inflamed knot in a hair follicle, which grows into a golf ball at a dramatic pace. The thing looks grotesque, like a kind of baboon nose in the middle of my armpit, and is incredibly painful. I can’t work out for a week. During this week, a car needs to be driven from Great Britain to Sweden, with a dog, and I sit in the car for twenty-four hours with my husband and the carsick dog in the backseat, elevating my arm by holding on to the handle above the door, while poor Luna throws up.
An anti-inflammatory snack.
And so the first communication Rita has from me is not a well-written email with questions about why and how, but instead this:
Hi Rita,
I’ve come down with an abscess in my armpit the size of a golf ball, and have to sit with my arm elevated and can’t work out. I’ll be in touch when I feel better.
Maria
It sounds like the all-time worst excuse, kind of like ‘the dog ate my homework’. But it’s the truth.
The golf ball finally disappears, and I resume my new lifestyle. I move forward with baby steps but I fall down all the time.
It’s hard to follow the lifestyle at work. I’m out having lunch with a client, and I already know that she struggles with her weight. When she sees me order salad with smoked salmon and pass on the bread, she looks irritated.
‘But you don’t have to diet – look at me,’ she says.
‘This isn’t dieting,’ I say, defensively.
The intimacy that we used to have on a private level is marred by this conversation. I feel that she thinks I’m indirectly criticising her, which just isn’t true. I have friends who ask if I’ve become anorexic or developed a fear of fat when I turn down a piece of chocolate cake.
‘Don’t you eat anything anymore?’ they ask.
‘Yes, I eat lots, five times a day – I’m just eating different things.’
A TYPICAL ANTI-INFLAMMATORY DAY
A typical day in my life might look like this:
• 6:30 Meditation and gratitude. Make my bliss plan for the day: food, exercise, de-stressing, awe.
• 7:00 Smoothie with protein powder, almond milk, green powder, spinach, berries and nuts. Two cups of super strong tea with honey.
• 8:30 On my way to work, listen to my own bliss music.
• 10:00 At work I have two eggs, two rice cakes and some tomatoes that I’ve brought from home, plus a cup of coffee with real milk.
• 12:00 Leg day at the gym – squats, dead lifts, hip lifts, etc. My bliss music in the headphones.
• 13:00 A protein shake and an apple. After showering, I eat a bag lunch with leftovers from yesterday (chicken/fish, potatoes, etc.) that I’ve added to a big salad with colourful vegetables.
• 17:00 A bowl of kefir with chia seeds.
• 18:00 Twenty minutes of meditation with my spirituality app or deep breathing.
• 19:30 Dinner – salmon fried in coconut oil and turmeric, oven-baked sweet potatoes, cooked green beans, homemade pesto and a spinach salad, then a few pieces of dark chocolate and a cup of ginger tea.
• 22:00 Digital detox – time to calm down my system for the night. Reading and gratitude list.
Another friend accuses me of betraying the collective global feminism by focusing on my body and my food. I ask her if women will get higher pay just because I have back pain.
‘But those are patriarchal ideals for women,’ she says, clearly hurt.
‘Is it feminism when women don’t feel well?’ I continue.
I begin to realise that anyone who starts a big lifestyle change will always have to deal with other people’s reactions. Some of it is concern. Some of it is based on feelings. Suspicion? Anxiety about changes, because we want people around us to always be the same? Or does it come out of religion – a kind of asceticism, the idea that anyone who turns their focus on the body and their own lifestyle becomes self-absorbed?
I’m blown away by the resistance.
Rita and I begin communicating about all this.
I now understand that many people who change their dietary habits encounter exactly the same resistance from those around them – even at home. But Rita is not only smart and empathetic but also fun and ingenious, and she offers suggestions as to how I can meet these challenges.
She says I need to stand up for myself and my lifestyle more clearly, without placing blame on anyone else. If others then choose to feel bad about my choices, it’s their own problem. I need to learn this, again and again, and oh, how hard it is. I take it personally, and have always done so, if anyone in my circle feels bad because of something connected to me. I carry this like a heavy backpack, and I see the same phenomenon in many women around me. The trick is to lighten that backpack, since it’s no use to anyone. Then there are the practical issues.
My family protests because the cupboards and fridge are suddenly too full when I put in new, space-hogging things like bags of flaxseeds, hazelnuts and goji berries. The freezer is packed with different kinds of frozen berries and big bags of frozen vegetables. My husband, who has many wonderful traits, has a strict inner home economics teacher – we’re talking sturdy cooking lady from the 1950s here. He loves a semi-fanatical order in the cupboards and the doors closed, which becomes hard to achieve when my new foods have to jostle for space with the foods we’ve always eaten.
And all these new powders, where can I store them? Like L-glutamine, as it turns out it’s called, and green powders – a new phenomenon – and protein powder. That’s also new, this thing with protein powder. I use it either as an ingredient in my breakfast, with nuts and fruit (protein, fruit, fat as it’s called in Rita’s language), or after working out. I find a kind of protein powder at my local health food shop that tastes like banana muffins. The only problem is my stomach, which also turns into a banana muffin and starts to produce gas on a scale that could drive the heating system of a medium-sized town.
Another kind of powder turns my stomach into an even bigger balloon. Rita urges me to look for a protein powder that doesn’t make me gassy, and she recommends a vegan powder that’s easy on the stomach. But it turns out that one is impossible to dissolve in water without a blender.
So that’s how I end up on a trip with a client to Geneva with my immersion blender packed in my bag. I arrive early at the hotel, and the first thing I do is go down to the gym and do the day’s workout. Then I get out the wand from my luggage, and the powder I brought with me in a bag, and make a hotel room smoothie in the toothbrush glass, with the Swiss sparkling mineral water Gerolsteiner Sprudel.
In short, a sprudel schmoothie.
I’ve had better tasting drinks. But worse ones too.
Then there’s my mood. Is it the spring light here in Geneva? My fun travelling companions? Or is it . . . me?
Something is starting to happen.
’My family protests because the cupboards and fridge are suddenly too full when I put in new, space-hogging things like bags of flaxseeds, hazelnuts and goji berries.’
All my life through, the new sights of Nature made me rejoice like a child.
– Marie Curie, chemist and Nobel Prize winner
3. INSIGHT (#ulink_11a5ee1d-3d05-565f-b624-4c5bdf8aab9b)
It’s a spring night in Lund, Sweden, 2013.
It’s just the kind of fresh spring evening that creates such expectations of life, love and all the other wonderful things that belong to the light time of year. Students are riding their bikes towards the city centre. Trees are budding in the Lundagård park next to the cathedral’s sandstone walls. The magnolia by the cream-coloured university building will soon begin to bloom, just in time for May Day, when student singers will once again sing a welcome to spring and the beautiful month of May.
Together with the other members of the advisory committee that meets regularly in order to support the university’s big 350-year jubilee, I’m sitting in the old Biskopsgården, just below the library. At the last minute, I’ve decided to attend this meeting, even though my calendar is full. It will turn out to be a significant event.
Every time the group gets together, we have the privilege of meeting one of the most innovative researchers at the biggest university in the Nordic region. Today we’re going to meet a specialist in nutrition research. Professor Inger Björck is introduced and steps forward to talk about her brand-new research. Only a few minutes into her presentation, I realise that her findings are very important, even somewhat sensational.
She gives us a brief background.
Professor Björck leads the Center for Preventive Nutrition Research at Lund University. Scientists there are conducting interdisciplinary research about how a variety of diseases can be counteracted with a proper diet, as well as research into what is known as the metabolic syndrome.
The metabolic syndrome, a medical term that has become more and more common, includes three conditions: diabetes, obesity and high blood pressure. Each of these conditions carries risks. But together, they form a type of super risk for serious heart disease, stroke and other cardiovascular diseases. It is also suspected that this metabolic condition is connected to certain forms of cancer and even to an increased risk of dementia.
Researchers haven’t quite been able to explain the metabolic syndrome. One theory is that it has to do with insulin, the hormone released by the pancreatic gland when you eat sugar-containing foods and whose function it is to move the broken-down sugar into the cells. People with diabetes 1, which often begins to manifest in the teenage years or even earlier, lack the ability to produce enough insulin.
But there is also an acquired form that sneaks up on people later in life, diabetes 2. (Today there are researchers looking into whether there may also be a number of intermediate forms between diabetes 1 and 2, but we’ll leave that aside here for the sake of simplicity.)
To sketch out a simple explanatory diagram for this process, when you eat sugar and your blood sugar level rises, a signal is sent to the pancreatic gland, which releases insulin. The insulin is sluiced out and ‘opens up’ the cells in order to sluice in the broken-down sugar, along with proteins and fat.
When the body constantly takes in large amounts of sugar and insulin levels have to stay elevated in order to shuttle the sugar out of the bloodstream and into the cells, it creates a so-called insulin resistance. In other words, there is insulin in the blood that’s supposed to deal with the sugar, and that makes the insulin attach to the cells, but something goes wrong in the communication between the insulin and the cells. The cells simply lose their ability to react to the presence of insulin. The number of people who have metabolic syndrome is growing rapidly, because more and more people eat the wrong kind of food, have a sedentary lifestyle, and/or suffer from stress and other psychosocial problems.
The above-mentioned triple combination, with diabetes/belly fat/high blood pressure, used to be a medical condition that affected mainly older people. But now it’s increasing even among younger men and women. Altogether it’s estimated that one quarter of the adult population in the United States, Canada and Europe have metabolic syndrome. In short, we are talking about an epidemic that is increasing like an avalanche in the Western world, an enormous threat to public health.
In the past, each of these diseases was studied separately. But Inger Björck and many other researchers worldwide are now beginning to realise that the diseases are in fact connected.
‘Then you have to wonder, how can suffering be prevented?’ she says.
Inger Björck is carrying out innovative research in this area. For example, she’s studied mice that have been fed either a high-fat or a low-fat diet. In addition to that diet, the mice were given different berries and fruits like lingonberries, raspberries, prunes and currants. It turned out that the mice who ate berries – especially lingonberries – maintained the same weight regardless of whether they ate a high-fat or low-fat diet. The lingonberry group actually lost some weight, even with a high-fat diet.
Björck believes that the risk of diabetes 2 and coronary artery disease can be decreased by means of an entirely new method, a new category of food in which berries are part of a larger food group.
‘These foods are called anti-inflammatory,’ she says.
I make a note of the name. It calls to mind what I read about in Dr Perricone’s books ten years earlier.
Then Professor Björck begins to explain how these new foods can affect the whole person, not only blood pressure and cholesterol levels but also cognitive ability, or the brain function that includes a person’s intelligence, in the broad sense of the word – our capacity to think, remember, solve problems and learn new things. This research sounds both creative and worthwhile, and so far I’m following her presentation with interest. This is worth supporting, my professional self acknowledges in an observant yet slightly distant fashion.
But when she shows us the list of the foods the researchers have been using to achieve these results in people, I get a shock. A slow-motion lightning bolt strikes my brain, and I sit at the very edge of my chair, suddenly wide awake.
First, there are things like decreasing sugar, doing away with white flour, increasing the intake of all kinds of berries, increasing the amount of vegetables and fatty fish, and adding vinegar and probiotic supplements. But then comes a concrete list of foods, and it looks like . . . Rita’s food list?
My heart does a quiet leap of recognition and time stands still. I gaze around me at the old meeting room, with its view of the university library’s stepped gable in brick. The great linden trees shimmer with fresh new leaves in the spring evening.
What is this? Have I unknowingly been eating anti-inflammatory foods and thus affected my body much more deeply than I had realised?
The effects I’ve felt are exactly the ones that Inger Björck describes in her test subjects. They grew stronger, reduced their waistlines, expanded their mental capacity and developed more of a zest for life.
Or is it just an amazing coincidence?
After the talk, we are served an anti-inflammatory buffet that the researchers have designed themselves. They’ve even baked their own bread, similar to Danish rye bread, using whole barley. There are salads, fatty fish and nuts, and everything is delicious. Over one of the salads, I share my insight with another woman. I lean forward confidentially, almost a little embarrassed.
‘I’ve actually been eating like this for a few months. Or at least trying to.’
‘I thought you looked energetic, somehow,’ she says, looking at me appraisingly.
I go up to Professor Björck and tell her that there are in fact people who live like this every day but who haven’t quite made the scientific connection to anti-inflammation that Björck’s team has. They just do it because they’ve discovered that it works.
‘Who are they?’ she wonders.
‘Well . . . fitness people in the United States and Canada,’ I say.
She looks surprised. We agree to stay in touch. And that’s where my own journey of knowledge begins.
Inflammation and anti-inflammation. What is this all about? I have to learn more.
I begin racking my brain for long-ago facts from my university studies in immunology. I think I took that course in the red building at the old Veterinary College in Frescati in Stockholm, if I remember correctly, and we learned something about the two forms of inflammation – because inflammation is not always a bad thing.
The first type of inflammation is purely positive, a helping process. Imagine a cut from a kitchen knife, a finger squeezed in the car door, a urinary tract infection or a sore throat. When you’re injured or infected, your immune system starts producing inflammation as a defence mechanism. A teacher I once had used this image to describe it: imagine a land that is being attacked by an external enemy and wants to defend itself. That’s how the immune system works. The outer injury is the external enemy, the immune response is the country’s government and defence, and the inflammation is part of what you have to do to defend yourself. There are a number of different foot soldiers who help. These soldiers in turn have many different specialist functions, just like in a regular army, with bridge builders, telegraph operators, explosives experts and intelligence agents.
In human blood, the blood platelets constantly wander around looking for problems in the blood. The blood platelets gather around the problem – the cut, the bruise or the infected body part – and then send a chemical signal to the immune system.
‘Problem at g, come here right away,’ say the blood platelets.
The signal is intercepted by the white blood cells, who answer, ‘On our way.’
An advanced line of defence is set up, with many different types of foot soldiers. They’re called cytokines, leukotrienes, prostaglandins, chemokines, thromboxanes and so forth, and they function like support troops, where each one sets out with its own task. They expand the blood vessels at the site of the affected tissue and make the area around it more ‘transparent’. This means that more cells from the immune system can reach the injury, attack enemy bacteria, clean out old junk and then repair and build up new and fresh tissue.
In medical training around the world and through the centuries, students have had to learn to recognise an inflammation the traditional way, which originates with the ancient Roman Celsus, who wrote great reference books about the body. Celsus’s favourite treatment was to simply open the veins and empty out the ‘extra blood’, a procedure he recommended for many types of health problems, as well as for people ‘with big heads’. Celsus also described the signs of inflammation in Latin: rubor, tumor, caldor, dolor. Redness, swelling, warmth, pain. Which is exactly what you feel in your throat when you have a sore throat. These signs of inflammation can in turn be counteracted by RICE, or rest, ice, compression, elevation. (Exactly what you do with a sprained ankle.)
The whole point, in short, is that inflammation works like a kind of fire department. It rushes out, attacks the enemies, cleans out and repairs. Then the system goes back to resting status.
This acute type of inflammation has a rhythm. There’s an ebb and flow, a clear beginning and an end, and the rhythm signals a healthy and active immune defence. It isn’t this type of inflammation that’s problematic but rather another one, which seems to be affected by food and contributes to illness. I wondered who might be able to tell me more about it.
I investigate some more, and after a while I find a new trail. There’s a researcher in the United States, Barry Sears, who has been on this track for a long time and founded an organisation for research in that area, the Inflammation Research Foundation. I’m not able to travel to meet him, but I don’t want to just send him an email, since there’s so much that I don’t understand. We need to actually talk.
I’m able to reach him by phone, and he gets right to the point.
‘This is a new area for most doctors. I’ve been working in the field for a while, but in general way too little research has been done.’
He mentions how many different kinds of diseases the low-grade systemic type of inflammation is linked to. We’re talking about heart disease, high cholesterol values, diabetes, joint problems and neurodegenerative disease, but also certain forms of cancer.
‘But what exactly does this low-grade systemic type of inflammation do?’ I wonder.
He begins to explain very fast, and it’s hard to follow him since the connection breaks several times during our call.
‘Okay, how about this: I’ll send you a scientific article,’ Dr Sears says.
